New Global Campaign Takes on Noisy Leisure Activities

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Worldwide, the statistics are sobering:

  • 360 million people have disabling hearing loss.
  • 43 million people between the ages of 12–35 years live with disabling hearing loss.
  • Half of all cases of hearing loss are avoidable through primary prevention.

Of course, none of this likely comes as a surprise to ASHA members, particularly audiologists, who are on the front lines of care for people with hearing loss. The good news is that we are going to hear a lot more about this serious health issue with the help of a high-profile group.

Today, on International Ear Care Day, the World Health Organization is elevating the profile of hearing loss—specifically noise-induced hearing loss—by launching a new campaign called Make Listening Safe.

The campaign educates the public about hearing dangers posed by noisy leisure activities and promotes simple prevention strategies. Young people are the focus because an increasing number are experiencing hearing loss. As the creator of the highly successful Listen to Your Buds campaign, WHO asked ASHA experts to advise on Make Listening Safe. A role the association enthusiastically embraced.

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ASHA used Listen to Your Buds to provide an early warning on potential hearing dangers from misuse of personal music players and the need for safe listening. Today, as this technology is nearly ubiquitous, the campaign is going strong on a variety of fronts.

One of ASHA’s most successful ventures is its safe listening concert series. The series educates young children about protecting their ears in a fun, interactive way by bringing innovative musicians and performances to U.S. schools. A new video showcases the most recent concert series, which took place in six Orlando-area schools in conjunction with ASHA’s 2014 convention.

Misuse of personal audio devices is also a key area of focus for Make Listening Safe. According to WHO, among teenagers and young adults aged 12 to 35 years in middle- and high-income countries, nearly 50 percent are exposed to unsafe levels of sound from the use of these devices.

This is one of the new global estimates being released with the launch of Make Listening Safe. In addition to a high-profile unveiling in Geneva, WHO is issuing a variety of materials featuring statistics on the problem’s scope, the hearing loss consequences and action steps that parents, teachers, physicians, managers of noisy venues, manufacturers and governments can take to make listening leisure activities safer.

ASHA asks members to take up the campaign. Here are just a few ideas on how you can get involved:

  • Utilize the WHO’s eye-catching public education materials—including posters, a fact sheet, and an infographic—with peers, patients, friends and loved ones.
  • Engage in grassroots public education, such as sharing statistics and prevention tips on social media or holding a free hearing screening.
  • Approach local media to pitch a story. The campaign’s launch with accompanying statistics is a great news hook. You can tie the story to your local community by highlighting an event your practice is hosting or offer tips for safe listening at local noisy venues (e.g., stadiums, concert venues/clubs). This is also an excellent consumer health story for a television station, particularly because it offers “news you can use” such as easy prevention tips.

The focus on noise-induced hearing loss in young people is not limited to March. While the WHO campaign will be ongoing, ASHA will also poll the public about safe listening practices. Our results will provide more opportunity for outreach during Better Hearing & Speech Month in May and beyond. Stay tuned!

Click here for more information. Questions may be directed to pr@asha.org.

 

Judith L. Page, PhD, CCC-SLP, is ASHA’s new president. She served as program director for Communication Sciences and Disorders at the University of Kentucky for 17 years and as chair of the Department of Rehabilitation Sciences for 10 years. 

Noise-Induced Hearing Loss in Children—A Preventable Problem: Part 2

Jessica-RossiKatz-PodcastPodcast: Episode 29 (Part 2)
ASHA-certified Audiologist Dr. Jessica Rossi-Katz discusses the prevalence of noise-induced hearing loss in children, how to prevent it from occurring, and available treatment options. Read the transcript.

Listen to Part 1 of this podcast: Dr. Rossi-Katz discusses the background of noise-induced hearing loss in children and prevention strategies for parents.

Noise-Induced Hearing Loss in Children—A Preventable Problem: Part 1

Jessica-RossiKatz-PodcastPodcast: Episode 29 (Part 1)
ASHA-certified Audiologist Dr. Jessica Rossi-Katz discusses the prevalence of noise-induced hearing loss in children, how to prevent it from occurring, and available treatment options. Read the transcript.

Continue listening to Part 2 of this podcast: Dr. Rossi-Katz discusses signs of hearing loss in children, sources of noise in everyday life, and how audiologists treat such hearing loss.

Newborn Hearing Screening—In the Hospital and Beyond

Patti-Martin-PodcastPodcast: Episode 28
ASHA-certified Audiologist Dr. Patti Martin talks about what to expect from a newborn hearing screening, why it is important, and how to identify the signs of hearing loss within the first year of a child’s life. Read the transcript.

Untreated Hearing Loss in Older Americans

Sandra-GordonSalant-PodcastPodcast: Episode 26
With roughly 50 percent of Americans over 60 suffering from some form of hearing loss, Sandra Gordon-Salant, audiologist and ASHA fellow, discusses signs of hearing loss and available treatment options as part of ASHA’s new “Identify the Signs” campaign. Read the transcript.

How Bombs and Other Loud Booms Can Damage Hearing—and How People Can Get Help

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We live in a time of constant exposure to loud sounds. Some of them are completely unexpected and earsplitting, such as last month’s blasts at the Boston Marathon and explosions at the fertilizer plant in West, Texas, or the roadside bombs constantly encountered by military service members overseas.

The newspapers and television media share some of the awful lingering effects for survivors, particularly the physical and psychological trauma. Occasionally the media comment on the disorientation and temporary effects on hearing. But we seldom learn of the long-term effects that many of the survivors experience, especially in relation to hearing loss.

The hearing system is a wonderful and a very delicate tool that allows us to hear a wide range of sounds and words. We take our hearing ability for granted until something occurs to disrupt it. We attend a thunderous rock concert, watch booming 4th of July fireworks or listen to our electronic devices on top volume. Afterward we notice that we are not able to hear clearly for a while. But then our hearing gradually returns to what seems like normal, and we expose ourselves to that same noise again and again. Each time we do this, we increase the likelihood that our hearing will gradually be permanently affected—and we cannot get it back. This deterioration happens because the tiny sensory hair cells of the inner ear get destroyed. These cannot be restored!

Those who happened to near the Boston Marathon bombings were rendered disoriented and unable to hear by the sudden blasts. Some may have found their hearing improving and feeling OK by the next day. But others may now have a noise in their head that is either constant or intermittent—the result of the huge blast their ears were exposed to. These people may find it useful to speak with an audiologist about reducing the effects of this noise on their lives.

Others exposed to the blast may not be able to hear as well as they could before this traumatic event. Their speech may be unclear, or even greatly reduced, and they may hear themselves quite loudly but cannot hear others when they speak. They may wonder at the fact that others next to them have no such permanent effects. All of us are different. And for some reason, some of us can tolerate loud sounds a lot better than others and don’t seem to react as much as others. There is no way to predict at present who can tolerate loud sounds versus who cannot.

What can a person do when there has been a long-term effect on hearing? There are two groups of people who specialize in hearing disorders: Physicians who are ear, nose and throat specialists, and those who are doctors of audiology (audiologists). An audiologist has the training and knowledge to treat hearing disorders, and the physician is trained to treat medical issues related to hearing. Audiologists help those with noise in the ear or hearing loss reduce these effects. Physicians work to repair problems in the ear with medication and surgery.

But a physician’s work may not be enough to solve the problem, and that is when an audiologist may provide the most assistance. The important take-home message is that you do not have to live with deteriorating hearing. Reach out to audiologists and physicians, who can help you continue functioning well in society and access a high quality of life.

 

James Blair, PhD, CCC-A, is a professor of audiology at Utah State University and an affiliate of ASHA Special Interest Group 8, Public Health Issues Related to Hearing and Balance.

Giving Peruvian Children the Power of Communication

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In March, I traveled to Lima, Peru, with our Mercy College communications disorders program director, Helen Buhler, and a team of 27 physicians, surgeons, nurses, technicians and other SLPs. We were there as part Mercy College’s partnership with Healing the Children, Northeast, which provides primarily surgical services to children in need in the United States and abroad.

Over the week we were there, 37 children had surgery; some had traveled for 7 days to reach the hospital. We SLPs worked on parent training, peer training and direct service delivery. Here are some excerpts from the blog I kept during our visit.

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I cried when Dr. Manoj Abraham—a surgeon from Vassar Hospital—put the last stitch into the baby’s lip.

On Friday, Helen, Marianella Bonelli—an SLP and Mercy alum—and I visited with all the parents on the ward. For those whose children had had a lip repair, we celebrated together, admiring their beautiful babies. For those who had their lips repaired but still would need palate surgery in the future, we also gave advice on helping the kids develop good speech habits now to establish good airflow from the mouth after the palate is closed. We worked directly with the kids who had newly closed palates and their parents, teaching about how to bring the sounds out through the mouth and not the nose. Needless to say, there were many therapy materials, toys and goodies passed around, ensuring we went home empty handed but the kids did not.

After speech rounds, we put on fresh scrubs and went to surgery. Dr. Abraham was operating on a baby with a cleft lip that went up into her nose all the way, and welcomed us to observe him.

He was putting this baby’s nose together, carefully making it match the other side as much as possible. He worked some more on the deep layers of the lip, making sure it would be able to have free movement. Then he sutured the philtrum, the raised line that runs down from your nostril to the beginning of the red part of your lip. Suddenly, this baby had a sweet Cupid’s bow of a mouth…a mouth that would pout and pucker, shout, whisper…

Even though it was my second time in the OR and I thought I was over it, I cried and cried. Writing this now, I’m crying again.

What a gift.

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As I came into the speech office (a commandeered storage room), I saw Helen doing…arts and crafts? 

Helen always says we do cowgirl therapy on these trips—shooting from the hip. When an 11-year-old girl with cerebral palsy arrived with very few spoken words, and those few only intelligible to her mom, Helen created an old school low-tech augmentative communication device. She used paper, a sheet protector and some of our speech materials to create a board with some basic vocabulary.

The mom was thrilled to have a way for her daughter to communicate some wants and needs to others in her life. Helen showed her how to create more pages for the board as the child mastered its use. The mom’s eyes were shining—it was so obvious that the board would be implemented immediately.

Based on a quick evaluation, it was clear that the child understood a lot more than she could say, so we hope this is a way she can start to “say” something to the world at last.

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We also worked with a four year old boy with hearing loss due to a malformation of the external and middle ear. He has had recurrent ear infections and had drainage from one ear. He was taking an assortment of antibiotics, and his mom had a thick folder of medical records with her. Although his audiological testing shows a hearing loss, he is not currently a candidate for surgery (Dr. Ryan Brown graciously gave him an exam on the fly to double check).

Helen spent some time with the mom, teaching about behavior management, and I taught her about sign language. I taught them three signs: “go,” “more” and “eat.” The kid chased me around the grounds of the hospital, as we worked our way over to our surgical consult, and I would only run if he signed, “go.” We went from hand-over-hand to slight physical prompt, to following a model for the sign “go.”

The mother was shocked at how positive our interaction was—he was laughing as he chased me. Soon, this kid will experience the power of controlling his world through communication.

Score one for the speech department.

Shari Salzhauer Berkowitz, PhD, CCC-SLP, is an assistant professor at Mercy College in Dobbs Ferry, N.Y. She is an affiliate of ASHA Special Interest Groups 10 (Issues in Higher Education) and 17 (Global Issues in Communications Sciences and Related Disorders). Her research interests include cross-language and bilingual speech perception, multi-modal speech perception and integrating technology and instrumentation into the communication disorders curriculum.

 

Kid Confidential: Hearing Loss, Classroom Difficulties, and Accommodations

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(photo credit: sound waves via Bigstock)

Ah, the familiar sounds of rustling papers, fast paced walks from meeting to meeting room, and that all too common groan, a mixture of frustration and exhaustion in equal parts, remind me that it is that time of year in the schools.  It is “IEP season”.

In honor of the countless hours of reassessment, data collection, and paperwork completion you will be doing over the next few months, I thought I’d write a post to help out those of you who are once again, hitting the keyboards and staring at that blank section on your IEP.  You know the one I’m talking about.  You spend a lot of time thinking about it only after all the data and classroom observations are compiled.  You know it needs to be completed but after writing your student’s present level of performance, his goals and objects and of course his service time, who has the energy left to even think about classroom accommodations and modifications.  Well that is where I step in, at least for those of you who have students with hearing loss on your caseloads.

Last year at this time I had a few students with hearing loss managed with both hearing aids and cochlear implant (CI) on my caseload.  As a multidisciplinary team, we had to do some research to find appropriate accommodations and modifications for those students.  However, I recently read the book Children with Hearing Loss: Developing Listening and Talking Birth to Six, by Elizabeth Cole and Carol Flexer which provided some clinically useful information on the specific deficits a child with hearing loss might have in the classroom setting.  I wish I had read this last year while I was struggling with the multidisciplinary team to write an appropriate IEP.  But now that I found this information, I thought I would adapt parts of it and compile that information into a table for quick reference in the future.

The accommodations and modifications in the graphic below are suggestions of possibilities you may attempt to provide for your students.  This is by no means an exhaustive list nor would every student benefit from each suggestion.  Therefore, I recommend you use this list as a guide only while working collaboratively with your multidisciplinary team to determine appropriate accommodations and modifications for each student on an individual basis.

You will notice that the first accommodation for any hearing loss is the use of an FM system alone or in conjunction with auditory management (e.g. hearing aids, cochlear implant, other technology).  Research has shown the use of individual FM systems positively impact students with hearing loss of any severity level AND that classroom or sound field FM systems benefit ALL students.  One can’t help but wonder how different a student’s behavior would be in a classroom where the speech to noise ratio was in fact the recommended +15-20 dB rather than the typical +4 dB (Cole, Flexer 2007).  That is why the recommendation of an FM system is first as it is not only practical but very beneficial even for a child with very mild hearing loss.

Here are the levels of severity, classroom difficulties and possible accommodations and modifications for children with hearing loss.

You can download your copy of the above materials here.

I hope these materials help guide you and your multidisciplinary team when writing IEPs for your students with hearing loss.  Do you have additional modifications or accommodations you would add to this list?  Let us know by commenting below.

Thanks for stopping by and reading our second installment of Kid Confidential.  If you have any topics you would like us to discuss here, feel free to share.  You just might see your topic suggestion in one of the upcoming columns.  I’ll meet you back here on the second Thursday of next month.

Until then, remember, knowledge is power, so let’s keep learning!

References:

  • Cole, Elizabeth, and Carol Flexer. Classroom Accommodations for Students with Hearing Impairment. San Diego, CA: Plural Publishing, Inc., 2007. Print

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Maria Del Duca, MS, CCC-SLP, is a pediatric speech-language pathologist in southern, Arizona.  She owns a private practice, Communication Station: Speech Therapy, PLLC, and has a speech and language blog under the same name.  Maria received her master’s degree from Bloomsburg University of Pennsylvania.  She has been practicing as an ASHA certified member since 2003 and is an affiliate of Special Interest Group 16, School-Based Issues.  She has experience in various settings such as private practice, hospital and school environments and has practiced speech pathology in NJ, MD, KS and now AZ.  Maria has a passion for early childhood, autism spectrum disorders, rare syndromes, and childhood Apraxia of speech.  For more information, visit her blog or find her on Facebook.

ASHA’s Listen To Your Buds Campaign Brings Safe Listening Message to The 2013 International Consumer Electronics Show

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Annette Gorey, ASHA’s Public Relations Specialist, works to get ASHA’s booth ready for the show.

More than 150,000 people may hear more about ASHA’s Listen to Your Buds campaign at this week’s 2013 International Consumer Electronics Show (CES) in Las Vegas. This marks ASHA’s fifth consecutive year as a CES exhibitor, and the ASHA Public Relations team couldn’t be more excited to spread the word about listening safely and preventing noise-induced hearing loss.

The Listen to Your Buds exhibit will be in the heart of the CES Digital Health Summit. And new this year, ASHA joins the show’s MommyTech Summit to connect with influencers, mommy bloggers, key children’s health and technology media and more. We’ll convey how Listen to Your Buds can help parents help young people use personal audio technology safely. As you probably well know, the parent blogosphere is more powerful than ever and growing fast. This is an increasingly important audience for our Listen to Your Buds campaign and outreach efforts.

The time has never been riper for a safe listening message. Spend a day with a toddler, elementary school student, tween or teen – or just walk around the mall, stand in line at Starbucks or stroll down the street – and you can’t help but see how kids are more connected to personal audio devices than ever before. Headphones have become a fashion item. The latest color iPod is in the hands of a six-year-old. Teens are at the gym listening to music. And this past holiday season, personal audio technology items were among the hottest gifts around. Now, in the wake of technology gift-giving and increased daily technology time, parents should monitor their child’s usage and volume levels and model safe listening behaviors – and the tips at www.listentoyourbuds.org can help.

We know even minimal hearing loss can affect children’s social interaction, communication skills, behavior, emotional development, and academic performance. Some parents are now realizing this, too. Eighty-four percent of parents are concerned that misuse of personal audio technology damages the hearing of children, according to the results of an online poll commissioned by ASHA last May. Parents also show overwhelming support for hearing screenings for tweens and teens—71% for 10- to 11-year-olds and 67% for 16- to 17-year-olds—according to a University of Michigan Mott Children’s Hospital National Poll on Children’s Health released just last month.

ASHA’s exhibit booth in the Living in Digital Times area has information about hearing loss prevention, warning signs of hearing damage, and how to find a local ASHA-certified audiologist using ASHA’s ProSearch. ASHA member and Las Vegas audiologist Dr. Daniel Fesler, CCC-A and Buds Coalition Musician Oran Etkin will be on hand to talk with attendees.

The Consumer Electronics Association (CEA), who puts on the CES each year, is among the Buds’ dozen dedicated sponsors; we joined forces in 2007. Recently, CEA President and CEO Gary Shapiro highlighted just how important the Buds message is. “As a longtime supporter of the Listen To Your Buds youth campaign, CEA represents companies that create audio technologies for listeners of all ages,” says Gary Shapiro, president and CEO of CEA. “We promote products, like noise-canceling and sound-isolating headphones, that help minimize outside sounds, and volume-controlled headphones that give control to parents of young children. New innovations are still to come that will help us practice and teach safe listening so that we can all listen for a lifetime.’”

Erin Mantz is a Public Relations Manager for ASHA.

Nothing Smaller Than Your Elbow Please

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Ear wax: We all have it. We all want it gone.

Most audiologists are often asked about ear wax. What is it? Why is it sticky? Why do I make so much? How can I get rid of it?

Say “yes” to ear wax.

Ear wax actually helps to keep your ears clean.

The wax traps dirt, dust and debris such as dead skin cells from the ear canal, dried shampoo and shave cream and possibly the occasional flea or gnat. This debris is held together by oil and wax secreted by glands living in your ear canal. The secretions also have natural antibiotic properties that help keep bad bacteria from growing in the warm dark and cozy environment of ear canals. And you thought it was just a nuisance!

What kind of wax do you produce?

Ear wax or cerumen comes in two varieties: wet (honey-colored and sticky) and dry (grayish and flaky). Ear wax type is highly heritable and considered a Mendelian trait that follows the laws of genetics. The trait of wet or dry ear wax was once attributed to a single gene but today, research has identified another gene contributing to this sticky situation. Your ear wax type was determined by your ancestry. Almost all people with European or African ancestry have wet wax. If you have northeastern Asian ancestry will most likely have the dry and flaky variety.

People have no trouble cleaning belly button lint and removing mucus from the nose, but most have no clue how to safely take care of excess ear wax. For most people the ear is self-cleaning and ear wax is removed by the natural flow of the wax out of the ear. Ear wax problems are typically self-inflicted. If you listen with ear phones for long periods of time, (at safe loudness levels please) wax can become trapped because the natural flow of wax out of the canal is blocked with the ear phone. However, most problems arise when the wax becomes impacted up close to the ear drum— down deep in the ear canal. This usually occurs from attempts to clean ear wax using implements of destruction such as cotton swabs, hair pins and tooth picks. If you choose to use these tools to clean your ears, you run the risk of puncturing the ear drum (ouch!) or impacting the wax in the canal in an area beyond the oil secreting cells. The soft wax dries up into a hard ball and can cause a temporary hearing loss or dizziness until it is professionally removed. Contact an audiologist if you think ear wax may be the cause of your hearing or dizziness problems. Audiologists will advise you on how to prepare for a professional ear cleaning. They often provide ear wax removal. And if you make more than is typical, the audiologist will schedule appointments once or twice a year to keep things under control.

Do you have too much of a good thing?

Stress (even physical exercise) and anxiety can increase wax production as well as medications that either activate or diminish the “flight or fight” response. Anatomical structures of the ear canal can cause wax to become trapped. When the ear canal twists and turns or narrows a bit, the wax will not easily flow from the canal. Even normal aging increases wax production.

Just as grandmother reminded us…put nothing smaller than your elbow in your ear and let Mother Nature do her work.

What other common questions do you get from patients in your audiology practice?

Pamela Mason, M.Ed., CCC-A is the director of audiology professional practices at the ASHA national office. She is a member of ASHA’s SIG 8, Public Health Issues Related to Hearing and Balance.